Randy Mahon, APRN-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

59883 Issued in WV

Practice address

85 Birch Rd Apt 2
Louisa, KY 41230-9220

Phone

(304) 928-7387

NPI assigned

Aug 8, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• App of Tennessee Ed, PLLC

  • Emergency Medicine Physician
  • Maryville, TN
  • NPI 1003230236
  Medicare reassignment NPD
• Comprehensive Health Solutions, PLLC

  • Adult Medicine Physician
  • Williamson, WV
  • NPI 1932434149
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598832000000",
    "number": "1598956930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 568",
            "city": "WILLIAMSON",
            "state": "WV",
            "postal_code": "256610568",
            "telephone_number": "304-928-7387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 BIRCH RD APT 2",
            "city": "LOUISA",
            "state": "KY",
            "postal_code": "412309220",
            "telephone_number": "304-928-7387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHON",
        "first_name": "RANDY",
        "name_prefix": "Mr.",
        "credential": "APRN-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-08",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "59883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walter Kewin Lyons, PSS
• Keith Clay Lyttle, PSS
• Elizabeth Anna Madden, PSS
• Joseph Madden
• Shaina Marie Madden, PSS
• Bertha Celeste Crume Maldonado, TCM
• Anthony Peter Mallozzi, RPH
• Britanee Manifold
• Chasity Mann, PSS
• Jamie Mann

• Family Nurse Practitioner in Louisa, KY
• Providers in Louisa, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.